Extant research demonstrates a reliable relation between trait-level activation of the Behavioral Inhibition System (BIS) and symptoms of posttraumatic stress. Behavioral inhibition involves a general sensitivity to negative outcomes and is believed to contribute to the maintenance of PTSD through increased risk of avoidance and hypervigilant behavior. Despite clear evidence of a relation between BIS and posttrauma symptoms, factors altering this relationship have received little attention. Anxiety-related safety behaviors (SB) are identified as actions performed by an individual intended to prevent or mitigate some feared outcome or associated distress (e.g., carrying weapons in public). Aims of the current research were to examine the unique and interactive associations of BIS and SB with posttrauma symptom dimensions of intrusion, avoidance, alterations of cognition and mood, and alterations in arousal.
Participants (N = 135; 77.0% White/non-Hispanic; 74.8% female) were undergraduates involved in an ongoing study examining interpersonal and functional outcomes after Criterion-A trauma. Behavioral inhibition was assessed using Carver & White’s (1994) BIS scale. Trauma-related safety behaviors were examined using a 24-item measure targeting the frequency of participant actions intended to prevent feared outcomes and/or distress (e.g., travel with a “safe” person, stand near exits in public places). Posttrauma symptoms were evaluated using scores from the PTSD Checklist for DSM-5 (PCL-5). Direct and interactive relationships of safety behaviors and behavioral inhibition on PTSD symptom dimensions were examined through a series of regression models controlling for participant gender. Effect sizes were given as partial correlations (pr; small = 0.14; medium = 0.36; large = 0.51; Cohen, 1988).
Unique effects for SB were found for avoidance (p < 0.001, pr = 0.46), cognitive distortion (p < 0.001, pr = 0.37), and re-experiencing (p < 0.001, pr = 0.45) clusters with increases in safety behavior associated with higher symptomology. A unique effect of BIS was found only for symptoms of avoidance (p = 0.048, pr = 0.17). By contrast, a significant interaction of BIS and SB (p = 0.013, pr = 0.22) was noted for alterations in arousal. Simple slopes revealed that BIS scores evidenced a reliable association with symptomatology only at high levels of SB (p = 0.005, pr = 0.24). No relation was observed for individuals reporting low levels of SB (p = 0.534, pr = -0.06).
Results support previous findings that SB is a predictor of PTSD symptomology; however, effects in these data suggest the influence of SB may vary across individual symptom dimensions. SB showed a moderating effect on BIS for alterations in arousal and direct effects for other symptom clusters, suggesting the influence of SB in PTSD is complex.
Kenneth McClure– University of Wyoming, Cheyenne, Wyoming
Adam Ripley– Student, University of Wyoming, Laramie, Wyoming
Shannon Blakey– Doctoral Candidate, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
Shira Kern– Graduate Student, University of Wyoming, Laramie, Wyoming
Ryan Kozina– Doctoral Candidate, University of Wyoming
Joshua Clapp– Assistant Professor, University of Wyoming, Laramie, Wyoming
University of North Carolina at Chapel Hill
Chapel Hill, North Carolina
Shannon Blakey, M.S., is a Clinical Psychology Doctoral Candidate at the University of North Carolina at Chapel Hill. Her research centers on the cognitive and behavioral mechanisms involved in the maintenance and treatment of anxiety and related disorders. She also trains and supervises graduate students, post-baccalaureate research assistants, and undergraduate students in the assessment, treatment, and study of psychopathology. Ms. Blakey publishes research on the maintenance and treatment of anxiety disorders in peer-reviewed journals and is a regular presenter at ABCT conventions.